Therapeutic device for use in manipulative treatment of joints of the human body



S. THERAPEUTIC DEVICE FOR USE IN MANIPULATIVE April 29, 1958 H. WHITELAW3 TREATMENT OF JOINTS OF THE HUMAN BODY Filed May 2a, 1956 2Sheets-Sheet 1 w n F INVENTOR. STEPHEN WH/TELAW ATTORNEYS Apnl 29, 1958s. H. WHlTELAW 2,832,334

THERAPEUTIC DEVICE F OR USE IN MANIPULATIVE TREATMENT OF JOINTS OF THEHUMAN BODY Filed May 23, 1956 2 Sheets-Sheet 2 .g h EH53 5 30 as 3/INVENTOR. STEPHEN H. WH/TELAlW BY WW v ATTORNEYS United States PatentTHERAPEUTIC DEVICE FUR USE IN MANlilPU- LATIVE TREATll HENT OF JOINTS OFTHE HUMAN BODY Stephen H. Whitelaw, Newington, Conn.

Application May 23, 1956, Serial No. 586,766

9 Claims. (Cl. mil-25) The present invention relates to therapeuticdevices and, more particularly, to a novel therapeutic device for use inthe manipulative treatment of joints of the human body.

Frequently human joints are adversely affected by illness or, accidentresulting in stiffness and lack of mobility of the joint. in many cases,such malfunctioning or disability of the joint can be alleviated byproper manipulativetreatment, but relatively little use of suchtreatment has been made because it is diflicult to self-administer andusually has to be done frequently and over long periods of time to beeffective. Even with the assistance of skilled personnel, suchtreatments are frequently painful and too irregular for maximum benefit.

it is an aim of this invention to provide an inexpensive light-weightportable therapeutic device which is suitable for use on any of themajor joints of the body such as the Wrist, shoulder, elbow, knee orankle and which may be operated by the patient himself to impart motionto the joint and also to exercise the ad ductor and abductor or flexorand extensor muscles of the affected joint through the application ofexternal force.

It is another aim of this invention to provide a therapeutic device ofthe type described which may be used by patient to move the joint andexercise the muscles associated therewith by the use of these muscles tooperate the exerciser against a preselected resistive force.

it is still another aim of this invention to provide a device of thetype described which will produce the desired movements of the joint ina fully controlled manner and with visible indication of the operationso as to provide maximum therapeutic benefits, which is of simple andeconomical construction and comfortable to use, and which isparticularly adaptable for home use with a minimum of instruction andtraining.

Other objects will be in part obvious, and in part pointed out more indetail hereinafter.

The invention accordingly consists in the features of construction,combination of elements and arrangement of parts which will beexemplified in theconstruction hereafter set forth and the scope of theapplication of which will be indicated in the appended claims.

in the drawings:

Fig. l is a perspective view of an embodiment of a joint manipulatingdevice constructed in accordance with the invention as applied to aWrist.

Fig. 2 is a perspective view of the device of Fig. 1, taken from theopposite side.

Fig. 3 is a perspective view of the device of Fig. l as applied to awrist but turned 90 from the position shown in Fig. l; and

Fig. 4 is a fragmentary longitudinal cross-sectional view of the device.

The drawings and the following description describe the invention asused in connection with a Wrist joint. However, it is of course to beunderstood and will be readily apparent that the invention is equallyapplicable to any of the major joints of the body, and that the specificuse of the invention described herein is for example only.

ice

With reference to the drawings, a therapeutic device constructed inaccordance with the invention is comprised of a pair of oppositelyextending lever arms 10 and 11. The lever arm it has slidably mountedthereon a pair of L-shaped brackets 12 and 13. The brackets may besecured in any adjusted position longitudinally of the lever arm 10 bymeans of the thumb screws 14.. In the specific embodiment shown, a sling17 adapted to cradle a forearm, as shown in dotted lines in Figs. 1 and3, is suitably attached to the brackets 12 and 13 by means such as thescrews 15. The sling is preferably padded as indicated at 17 and isprovided with straps l8 and 19 to secure the forearm in the sling.

As shown in Figs. 1 and 2, the lever arm 21 is pro vided with a U-shapedbracket 22 slidably mounted there on. The bracket 22 may be secured inany adjusted position longitudinally of the lever arm 11 by the thumbscrew 23, and is provided with hand grips 24- on each of its legs for apurpose to be hereinafter described. In Fig. 3 a modified bracket 22a ismounted on the lever arm 11 in the same manner as the bracket 22, and isprovided with a cross-piece 25 having a hand grip 24a mounted thereon.The reason for the variation in structure between the brackets 22 and22a will be fully apparent from the description of operation of thedevice hereinafter appearing.

With particular reference to-Fig. 4-, the lever arm 11, in theembodiment shown, is connected to and is preferably integral with acircular plate member 28 disposed coaxially of a cup shaped casing orhousing 29 having a radially extending portion 30. The radiallyextending portion 30 of the casing has an end portion 31 of reducedthickness having a recess 32 in which the lever arm 10 is received andretained by means such as the screw 33. A pinion 36 is disposed withinthe casing 29 and is fixed to a shaft 37 extending through and journaledin the casing as at 38. An operating handle 39 is secured to the shaft37 externally of the casing 29 as by means of the setscrew 46. When itis desired;

to lock the handle 39 and hence the shaft 37 and pinion 36 againstrotational movement, this is accomplished conveniently by the slidelatch 4-1 which can he slid into engagement with the notch 42.

A gear engaged with the pinion 36 is disposed within the casing 29 andis rotatably mounted on a shaft 46 which is journaled in a boss 44internally of the casing 2h. One end of the shaft 46 extends through theplate member 28 and is provided at said one end with a radiallyextending flange 47 received in a recess 48 in the plate member 28. Theother end of the shaft 46 extends outwardly of the casing 29 and isthreadably engaged with an adjusting cap nut 4?. The cap nut $9 isprovided with an axially extending recess 50 in which is received aspiral spring 53 surrounding the shaft 46, the spring 53 being engagedat the other end with the casing 29. A pin 5J4 extends diametricallythrough the shaft 46 and is received within a slot 55 extendingdiametrically of the boss 44 to prevent rotation of the shaft relativeto the casing during adjustment and permitting movement: of the shaftaxially of the casing.

The boss 44 of casing 29 engages upon the upper side of the gear 45while a friction member :36 is disposed between gear 45 and the platemember 23. The purpose of the friction member 56 is to provide ayieldable connection between the gear 45 and plate member 28 whose forcecan be varied by adjusting the cap nut 49. Since there is only a metalto metal contact of small area between boss 44 and gear 45, littlefrictional force is exerted between these two members. i

In the use of the device as shown in Fig. l, the lever arm it) isattached to the forearm through the use of the adjustable sling 1'!" insuch position that the shaft 46 is coaxial with the pivot point of thewrist. The bracket 22. is then adjusted to receive the hand as shown. Inorder to condition the device for the application of an external force,the cap nut 4-9 preferably is turned down sufiiciently to preventslippage of the gear 45 relative to the plate member although, ifdesired, the force of spring 53 may be adjusted by backing off the capnut 49 to permit slippage and thus limit the maximum force which can beapplied to the joint. After the device is in place, the handle or knob39 is turned by the patient to apply force to the hand through thegearing 36, 45 and friction member 56 to the lever arm 11. As will beapparent, the bracket 22 by engagement with the hand will pivot thewrist relative to the forearm in a plane normal to the general plane ofthe hand. Movement of the wrist can, of course, be accomplished ineither direction from the median position of the Wrist wherein the handis aligned with the forearm. flexion of the Wrist for use in determiningimprovement in the condition of the joint, indicia are provided on thecasing as at 60 and a pointer 61 mounted on the lever arm 11 as is mostclearly seen in Fig. 2.

If it is desired to have the patient manipulate the joint by the use ofthe wrist muscles themselves, the slide latch 41 is moved to the lockingposition as shown in Fig. 2 to prevent rotation of the pinion 36.Henceforth, any movement of the lever arm 11 relative to the lever arm10 Will be opposed by the resistance offered by the friction member 56disposed between the gear 45 and plate member 28. As described abovethis resistive force of the friction member may be varied by adjustmentof the adjusting cap 49 to increase or decrease the force imposed on thefriction member by the gear 45 and plate member 28. To provide anindication of the resistive force opposing relative movement of thelever arms Ill and U. and thus provide a comparative indication of theimprove ment in the stren th of the muscles, indicia are provided on thecasing 25 as at 62 and a pointer .63 mounted on the cap 49. In the useof the device as last described, the patient grasps one of the handgrips 24 and moves his hand in a direction to exercise the flexor andextensor muscles of the wrist.

In Fig. 3 the device is illustrated as being used to pivot the wrist inthe general plane of the hand. As can be seen in Fig. 3, to enable thepatient to engage the lever arm 11 in a manner appropriate for this typeof manipulation, a modified bracket 22a having a crosspiece, or fingergrip 25 extending between the leg of the bracket is mounted on the leverarm 11. By positioning the finger grip 25 far enough out on lever arm11, the patients fingers can encircle the finger grip and exert movementof the joint. The manner of using the device is identical with themanner described above in connection with Fig. 1 in that the lever arm11 may be pivoted relative to the lever arm 10 either by rotation of theoperating handle 31 or through the use of the muscles of the affectedjoint themselves.

It should be apparent that the device is suitable for use on such jointsas the shoulder or knee by the provision of appropriate means on thelever arms 10 and 11 to secure the lever arms relative to the limbs oneither side of the joint. Thus, it can be seen that there has beenprovided a joint manipulator of simple, economical constructionparticularly adapted to home use by a patient and which requires aminimum of skill or training to operate. The exerciser is versatile inthat it may be adapted for use on all major joints of the body and isobviously rugged and capable of extended usage.

As many changes could be made in the above con struction and manyapparently widely different embodiments of this invention could be madewithout departing from the scope thereof, it is intended that all mattercon- In order to indicate the amount of d tained in the abovedescription or shown in the accompanying drawings shall be interpretedas illustrative and not in a limiting sense.

It is also to be understood that the language used in the followingclaims is intended to cover all of the generic and specific features ofthe invention herein described and all statements of the scope of theinvention which, as a matter of language, might be said to falltherebetween.

l claim:

1 t r 1. I r

treatment of joints of the human body comprising a first member havingmeans for attachment to the body on one side of a joint, a lever armpivotaily connected to the first member and having means for engagementwith the body on the other side of the joint, manually oparable meansmounted on the first member for pivoting the lever arm relative to thefirst member, a friction clutch between the manually operable means andthe lever arm, and means for latching the manually operable means toprevent movement thereof.

3. A therapeutic device for use in the manipulative treatment of jointsof the human body comprising a first member having means for attachmentto the body on one side of a joint, a lever arm pivotaliy connected tothe first member and having means for engagement with the body on theother side of the joint, manually operable means mounted on the firstmember for pivoting the lever arm relative to the first member, afriction clutch between the manually operable means and the lever arm,means for varying the effective force of the friction clutch, and meansfor latching the manually operable means to prevent movement thereof.

4. A therapeutic device for use in the manipulative treatment of jointsof the human body, comprising a first lever arm for attachment to thebody on one side of a joint, a second lever arm for attachment to thebody on the other side of said joint, a pivotal connection. for saidlever arms, comprising gearing operatively connecting said lever arms, afriction clutch associated with said gearing, means for locking saidgears against relative rotation, whereby pivotal movement of one leverarm is opposed by said friction clutch, and a manually operated handlefor rotating said gears whereby one lever arm is caused to pivot aboutsaid pivotal connection.

5. The combination of claim 4, further including means for varying thetorque transmitted by said friction clutch.

6. The combination of claim 4, further including indicia carried by saidpivotal connection for indicating the angular displacement of said leverarms.

7. The combination of claim 4, further including attachments for saidlever arms for attachment to the limbs of the patient and means forvariably positioning said attachments on said lever arms.

8. The combination of claim 7, wherein one of said attachments isprovided with a hand grip to be gripped by the fingers of the patient.

References Cited in the file of this patent UNITED STATES PATENTS2,387,966 Zander Oct. 30, 1945 Magida Nov. 29, 1955

